00;00;00;17 - 00;00;06;19 Dr. Winn I'm Dr. Rob Winn and you're listening to Real Cancer Talk from VCU Massey Comprehensive Cancer Center. 00;00;07;14 - 00;00;34;26 Dr. Winn Dr. Winkfield it is so good to have you, here at the AACR conference. The annual conference. It has been fantastic. You know, I know it's been a couple days. And I know you've been to a couple of these as far as I have. Can you tell me what you think, in the context of equity, in the context of disparities or the context of just the science? 00;00;34;29 - 00;00;37;26 Dr. Winn How are you seeing this, this conference grow? 00;00;37;28 - 00;00;55;27 Dr. Winkfield Yeah. Rob. It's such an honor to be with you. Thank you so much. And I tell you, this meeting has been blowing my mind. Just the the sheer volume of topics that are related to health disparities. I remember when I started coming to AACR, you know, 10 or 15 years ago, this wasn't the case at this meeting. 00;00;55;29 - 00;01;25;10 Dr. Winkfield There's been a significant shift, not only in terms of the number of abstracts or presentations, that there are related to health disparities and health equity areas. But the quality and the types of research. Now, some of that's related to the fact that, you know, technology's blowing up, right? So we have the ability to do science in a very different way, where we can start to ask some of those questions that are so meaningful in a very unique and different way because of technology. 00;01;25;10 - 00;01;48;11 Dr. Winkfield However, you and I both know that funding is key, and the fact that there has been substantive investments from the National Cancer Institute and other funding bodies to really make disparities research an important topic has really revolutionized it's changed the game for those of us who've been interested in doing this for a long time. 00;01;48;13 - 00;02;19;22 Dr. Winn But like the odds, I hear you. You know, I was thinking back to something that I had heard recently, from Doctor Fauci, who is a guy that's lived through two pandemics. And what he said he learned two things for certain. One was that the investment, as you're getting hinting at the investment of scientific and clinical research, pays off both in the development of, back then, HIV, the first pandemic that we dealt with, of coming up with AZT and other drugs now so that we don't really think of HIV and Aids as a death sentence. 00;02;19;23 - 00;02;40;25 Dr. Winn Right. But we actually learned that lesson also in the context of Covid with the mRNA vaccines. The second thing he said, though, is that in both, it was a glaring example of disparity and those at risk groups. The light wash put on them even brighter about the disparities we actually have in the United States. How do you think? 00;02;40;25 - 00;03;00;02 Dr. Winn And particularly, I mean, you're an outstanding radiation oncologist. You're an outstanding administrator, outstanding thought leader has published, I mean, really some impactful papers that I still admittedly have a couple at my desk that I read. But having said all that, as you're thinking about where the areas where health equity research and the impact of health equity is going. 00;03;00;05 - 00;03;01;12 Dr. Winn What do you see for our future? 00;03;01;13 - 00;03;21;00 Dr. Winkfield Yeah. Well, you know, you and I wrote 1 or 2 of those papers. I'm just saying, we did that together in this. But here's the deal. We have got to move. And I think we're now there, and we're we've got to continue to move in this direction when we stop describing the problem. Here's the disparity. Black people are doing worse. 00;03;21;00 - 00;03;27;07 Dr. Winkfield You know, they have this increased risk. We know this already. Can we start coming up with a few solutions? How about that? 00;03;27;08 - 00;03;30;16 Dr. Winn You said keep saying the same movie over and over. But I seen that. Seen. Right. 00;03;30;17 - 00;03;31;09 Dr. Winkfield Been there, done that. 00;03;31;10 - 00;03;32;00 Dr. Winn Been there, done that. 00;03;32;01 - 00;04;03;28 Dr. Winkfield Right. And so now again, the science that we're seeing here at ACR, there is real methodology being applied to looking at the difference between race and ancestry and how the two might be related, but how we also need to start thinking about those social determinants of health, those structural barriers, those things we wrote about, you know, that have been in existence for a long time, that have created an environment in this country which actually predisposes certain communities to being at risk not only for increased incidence of cancer, but worse outcomes. 00;04;03;28 - 00;04;22;16 Dr. Winn But worse outcomes. You know, you bring up a good point in where you are in, Tennessee and, you know, you're Vanderbilt Meharry, and where I am in Richmond, you know, the Confederacy at the time. But, you know, VCU Massey Cancer Center. It's interesting that some for me of the best research is coming out of those places. 00;04;22;17 - 00;04;41;29 Dr. Winn Yeah. And in fact, I think what I hope for the future of both collaborating and bringing on board, not only are institutions where, you know, there are obviously people doing the research, but actually making sure that the people doing the research who are doing this understand that it's not just about the research, it's about the impact of the research. 00;04;42;01 - 00;04;49;16 Dr. Winn And I think you've been able to really frame that better than anybody. And I was wondering if you could just talk about that a little bit about the need, the impact. 00;04;49;18 - 00;04;56;19 Dr. Winkfield Well, I, I'm laughing and chuckling because I even was trying to think about my own career. You know, I'm a biochemist, right. And I. 00;04;56;26 - 00;04;57;08 Dr. Winn We know. 00;04;57;08 - 00;05;14;14 Dr. Winkfield That in the lab and doing all this work. And I said, man this is not going to impact the people that I'm concerned about. Definitely not right away. But certainly I'm at an institution that I couldn't even get samples from black women. They weren't being included in the clinical trials. Right. So. 00;05;14;16 - 00;05;30;28 Dr. Winkfield I think it's so important to make sure that everyone has the ability to, to participate in cancer research a whole other. Right. But then I was like, all right, well, I'm going to be the best clinician, the best radiation oncologist I can be, but then I'm. 00;05;31;00 - 00;05;49;15 Dr. Winkfield Man, this ain't hitting it either, right? So that's where I really start to say, how can I start to move the needle in a different way? How can I start to vocalize the importance of the things that we see? How do we start to move the needle? How do we start to push the envelope when it comes to encouraging people to do science in a different way, right. 00;05;49;18 - 00;06;10;11 Dr. Winkfield And really being thoughtful about what is it that truly matters? We are spending trillions of dollars every year on cancer disparities, right? So if we want to talk about the financial impact, that's one thing, right? But when we want to say, how do we actually move the needle, how do we impact and change the outcome? We've got to rethink how we're doing things. 00;06;10;11 - 00;06;28;25 Dr. Winkfield The descriptive stuff isn't enough. And so that's why I started to really be the mouth if you will. I'm really just trying to say we have got to do things differently. And I do think that having a basic science background I think similar to you. Right. I mean both before. Well, by us being like physician scientists, we can speak both languages. 00;06;28;25 - 00;06;32;19 Dr. Winn What is a molecule? The medicine. Be okay with that? 00;06;32;22 - 00;07;01;06 Dr. Winkfield Yes. So I do think that that's an important consideration is really the, the, the need to say there are not just the structural barriers, but how do the structural barriers actually impact the biology of individuals? How does persistent poverty impact generations the same way that we know that if a woman is smoking, that her fetus has epigenetic modifications that actually predispose that child to being obese, and not only that child, but that child's child to be obese, right? 00;07;01;09 - 00;07;22;25 Dr. Winkfield How why are we not looking at the same things when it comes to racism, race based discrimination? All of the the redlining that we know is still in existence, right? Yes. While, you know, that government program was shut down back in 68, we still see the vestiges, right? It's still there. It's still there. And we have medical redlining. 00;07;22;25 - 00;07;40;08 Dr. Winkfield You know, that's from my perspective, one of the things the huge barriers that we see where poverty, people who are on Medicaid, people who might be disabled or differently abled aren't able to gain access. That's one area. And that's a part of research we need to do. We do need to think about health economics research and policy research. 00;07;40;08 - 00;07;49;26 Dr. Winkfield That's important as well. But let me tell you, those same policies are impacting the biology as well. And so we need to start looking at that. And I think we are this meeting is showing some great stuff. 00;07;49;26 - 00;07;55;15 Dr. Winn That we're starting to make that progress. Our understanding that it's basic not over basic and. 00;07;55;15 - 00;07;56;10 Dr. Winkfield Yes sir. Right. 00;07;56;10 - 00;08;02;05 Dr. Winn The translational and the population you're all aligning to actually have the impact. Yes. 00;08;02;05 - 00;08;03;02 Dr. Winkfield That's it. That's it. 00;08;03;02 - 00;08;19;22 Dr. Winn That's why yes it is. This is this is my thing that. Lizzie. I will be seeing you soon, I hope. There's going to be another ACR, and I'm going to give the props out to John Compton and everybody else in the mix for a large photo. Everybody else in Philly with the ACR for putting on a wonderful conference. 00;08;19;29 - 00;08;26;06 Dr. Winn But we know that in September, the ACR Health Disparities Conference is happening in California. So I'll see you there. 00;08;26;07 - 00;08;27;26 Dr. Winkfield Yes, absolutely. I'll be there. 00;08;27;26 - 00;08;39;15 Dr. Winn Now. Okay.